What is Glaucoma?

Glaucoma is a name for a group of eye conditions that cause gradual damage to the optic nerve (the link between your eyes and brain). This usually happens when fluid known as aqueous humour builds up in your eye, which increases pressure and damages the optic nerve as a result. Glaucoma usually affects both eyes, but one eye can sometimes be a bit worse than the other. The symptoms of glaucoma often don’t appear until it’s almost too late to treat it. It can ultimately lead to loss of vision, so it’s important that the condition is managed appropriately. 

Types of Glaucoma

Open Angle Glaucoma

This is the most common type of Glaucoma, which slowly develops over time. The drainage system in the eye gradually becomes blocked, so fluid can’t drain properly. As a result, pressure inside the eye rises. 

Angle Closure Glaucoma

Some people develop this over time, while others experience it suddenly. If angle closure glaucoma is experienced suddenly, it’s considered a medical emergency. Angle closure glaucoma occurs when the iris bulges and blocks the drainage system as a result. 

Normal Tension Glaucoma

Glaucoma usually involves pressure rising within the eye, but this type of glaucoma doesn’t. With normal tension glaucoma, the optic nerve becomes damaged, but the pressure in the eye doesn’t rise above the average range of eye pressure (between 10-21mm Hg). 

Congenital Glaucoma

This is a rare form of glaucoma which occurs in babies or infants. They can be born with it, or it can develop during infancy. Glaucoma that occurs in childhood after three years old is usually referred to as juvenile glaucoma. 

Secondary Glaucoma

This type of glaucoma is caused by something identifiable, like another eye condition, eye injury, or advanced cases of diabetes. This is different from primary types of glaucoma, where there isn’t an identifiable cause.

What are the causes of Glaucoma?

Elevated Intraocular Pressure (IOP)

Your eyes constantly produce a liquid called aqueous humour, which normally drains away from the inside of your eyes, keeping pressure constant. However, if the fluid can’t drain away properly, this can cause pressure to build up within the eye. Glaucoma can develop when this pressure begins to damage the optic nerve.  

Issues with eye fluid drainage

If fluid in the eye doesn’t drain properly, this can create pressure and cause glaucoma or other eye conditions. This could be because of reasons like the drainage system doesn’t work correctly, trauma from an eye injury, or the eyes create more fluid than they’re supposed to. 

Genetic factors

If you have a family history of glaucoma, particularly if someone closely related to you has it, like a sibling or a parent, this can increase the risk of developing glaucoma. If you’re from a Black African, Asian, or Caribbean background, this could also increase the risk. 

Eye injuries 

Eye injuries like blunt trauma can cause glaucoma. These don’t penetrate the eye, but can create issues, like bleeding inside the eye and damage to the trabecular meshwork (a structure in the eye that enables fluid to drain), which can lead to glaucoma. Penetrating eye injuries can also cause damage to the trabecular meshwork and create other problems like inflammation and scarring, which can also lead to glaucoma. 

Age

The likelihood of developing glaucoma increases with age and is more common in people over 40 years old. 

Certain medical conditions

Some medical conditions, like diabetes and high blood pressure, can increase someone’s chance of developing glaucoma. Short-sightedness and long-sightedness can also increase the risk.

What are the symptoms of Glaucoma?

Many people actually don’t realise they have glaucoma as it usually doesn’t have any symptoms, especially in the early stages. Losing side (peripheral) vision happens first, and this can be discovered, along with raised pressure, by an optometrist during your routine eye test. However, if acute angle closure glaucoma occurs (which is experienced suddenly), this is considered a medical emergency and can create symptoms like: 

• Intense eye pain 

• Headache 

• Nausea and being sick

• Eye redness 

• Blurry vision and loss of vision 

• Rainbow-coloured rings or halos around lights 

How is Glaucoma diagnosed?

Your optometrist will carry out some tests to check for signs of glaucoma during routine eye tests. That includes assessing your field of vision, checking your eye pressure with a puff of air test, and looking at the health of your optic nerve. If they think you may have ocular hypertension or glaucoma, they’ll refer you to specialists like us at Newmedica to confirm a diagnosis and begin a treatment plan to help protect your vision.

Treatment options for Glaucoma

Eye drops & medication

For many people, using eye drops daily might be the only treatment they need. These help to lower your eye pressure by enabling the fluid inside to drain more easily or by reducing the amount of fluid produced in the eye. It’s likely that you’d need to use eye drops for the rest of your life to help ensure your vision is protected. You might need to try out different types of eye drops to find the ones that work best for you. To make sure your vision is stable, your eye pressure is under control, and everything is working well, you’ll be asked to come back for regular check-ups with your ophthalmologist. In some circumstances, oral medications might be given. 

Laser Treatment 

Getting laser treatment for glaucoma (selective laser trabeculoplasty, or SLT) is often helpful. SLT involves using short pulses of light to help gently lower the pressure inside the eye, which helps the fluid to flow out of the eye more easily. The National Institute for Health and Care Excellence (NICE) and recent studies have recommended using this type of laser treatment in early cases of glaucoma, which could mean that you won’t need to use eye drops. 

Sometimes, for patients who have acute angle closure glaucoma (which can cause a buildup of sudden pressure), we also use a treatment called YAQ laser peripheral iridotomy. With this treatment, your consultant will use a laser to create a very small opening in the outer part of the iris (the coloured part of your eye). This allows fluid to move more freely within the eye, which lowers pressure and helps to protect your eyesight. 

Surgerys

Surgery is often recommended when laser treatment and medication haven’t been successful. When considering which type of surgery is best for you, your ophthalmologist will consider several factors, such as the type of glaucoma you have, the anatomy of your eyes, and the severity of your glaucoma. 

The types of Glaucoma Surgery available 

There are several different types of surgical procedures for glaucoma. Here are some common ones: 

• Trabeculectomy: This is the most common surgical procedure. It involves creating a tiny opening in your eye (underneath the upper eyelid) to form a channel that allows fluid to drain away and lower pressure. 

• Aqueous Shunt Surgery: A small tube is implanted in the eye to help drain fluid.

• Minimally invasive glaucoma surgery (MIGS): This includes the use of tiny devices and instruments which create smaller incisions. This reduces the chance of complications, and recovery is often quicker compared to other surgeries.

How to prevent vision loss from Glaucoma?

You can’t prevent glaucoma, but detecting it early and getting treatment can help slow down or prevent vision loss. Here are some examples: 

• Attend regular eye tests: Glaucoma is often picked up during eye tests. By not attending these, glaucoma could go unnoticed because it usually doesn’t have any symptoms. At the same time, make sure you’re aware if anyone in your family has glaucoma, as you may need to go for more frequent eye tests if they do. 

• Protect your eyes: Wearing eye protection when you’re playing sports that have a risk of injury from impact or an object, as well as using power tools, can prevent eye injuries.

Discover professional Glaucoma Treatment with Newmedica 

We care for more than 306,000 private and NHS patients in over 30 convenient locations, with more on the way, and we’re dedicated to helping people protect their eyesight.Our compassionate and caring team will make sure to give you a warm welcome, hold your hand if you’re feeling nervous, and will be there to support you from your first appointment to your last. We know that many patients feel anxious about their glaucoma treatment, but our personalised patient care will help you feel comfortable and at ease when you walk through our doors.